Male Contraceptives

More Reliable Options Are Needed

The latest ruling by the American supreme court on abortion has sparked conversations around methods of contraception, but not just for women; the discussion has also shifted to include men. Half of the world’s pregnancies are unplanned; therefore, sharing reproductive responsibility between men and women could

help tumble this statistic down (2). This article examines the ways contraceptives affect women. Why are

there fewer contraceptive options for men? And what are the recent advances in male contraceptive technology?

 


Women bear most of the responsibilities to control reproduction; this comes with financial and health burdens that are not discussed much. Female contraceptives are more expensive and have considerably more side effects due to the hormonal changes they cause. Hormonal contraception has a discontinuation rate of 50 per cent after just one year (2). A study has linked oral contraception with the usage of anti-depression medication, especially in adolescents (3). Of the thirteen most popular contraceptive methods, only three options exist for men: a vasectomy, condoms or the withdrawal method. Men rely on techniques that are either permanent or unreliable (7).

 

Men should want to gain reproductive autonomy, especially in today's world, where more than ever in history, men are held socially and financially responsible for their offspring by the legal system. However, men are still less affected than women in labour and primary infant care. We argue that most men would prefer the option of choosing when to become fathers, as 76 % of men involved in a study showed an interest in getting male birth control (4). More than 90 per cent of women surveyed in South Africa and Scotland believed male contraceptives are a good thing (8).


Why is there less funding for male contraceptive research? Pharmaceutical companies find it challenging to market male contraceptives due to the high dropout rate of men in clinical trials. This fallout is due to the side effects, which includes acne, site pain injection, increased libido and mood swing (5). It is essential to note that women go through similar side effects but are more desperate to control their reproduction. In one study, most men surveyed showed an interest in contraception and said they would prefer an implant or injection as a contraceptive rather than the pill (2).


Several clinical trials are being conducted to determine the effectiveness of a gel hormonal combination of nestorone and testosterone, which is applied daily to prevent sperm production (2). For non-hormonal and non-surgical solutions, doctors in India have tested the RISUG, a gel injected behind the penis to prevent the transportation of sperm to the urethra during ejaculation. It is reversible with a second shot that will dissolve the gel (6). Other methods like gendarussa (a male herbal contraceptive extracted from the Justicia gendarussa plant) interfere with the enzyme found on the head of the sperm. This changes the morphology o